Aktuelle Behandlung des Kolonkarzinoms

Das kolorektale Karzinom stellt die zweithäufigste Krebserkrankung bei Männern und Frauen in Deutschland dar, jährlich sterben ca. 30 000 Menschen daran, die Neuerkrankungsrate beträgt ca. 73 000 Menschen pro Jahr. Das mittlere Erkrankungsalter für sporadische Karzinome liegt zwischen 70-75 Jahren, jedoch in Familien mit genetischen Veränderungen, die im Rahmen von hereditären Tumorsyndromen vorkommen, wesentlich früher (45. Lebensjahr). Die Prognose ist stadienabhängig. Die vor mittlerweile mehr als 10 Jahren eingeführte Vorsorgekoloskopie ab dem 50. Lebensjahr zielt zum einen auf die Entdeckung und Entfernung der Vorstufen, den Adenomen, zum anderen auf die Erkennung von frühen Karzinomstadien, um die Prognose der Patienten zu verbessern. Nach einer kurativen Resektion wird je nach Stadium eine adjuvante Therapie empfohlen, die zum Teil als Kombinationstherapie durchgeführt wird. Bei Patienten im Stadium IV mit isolierten Metastasen in Leber oder Lunge ist durch eine chirurgische Resektion eine Heilung zu erreichen, zum Teil auch erst nach vorangegangener Chemo(immun)therapie. Liegt eine diffuse Metastasierung vor, so stehen im Rahmen eines individualisierten Therapiekonzepts verschiedene Chemotherapeutika und zielgerichteten Substanzen zur Verfügung, jedoch ist eine Heilung dann unwahrscheinlich.

Colorectal carcinoma is the second most common cancer in men and women in Germany. Yearly, 30 000 people die from it, the rate of incidence is ca. 73 000 new cases per year. The average disease age concerning sporadic carcinomas is between 70 and 75 years, but in families with genetic alterations which occur in the context of hereditary tumor syndromes it is substantially earlier (45^th year of one’s life). Prognosis depends on the disease stage. The preventive coloscopy from the 50^th year of life onwards, meanwhile established for more than 10 years, aims on the detection and removal of preliminary stages, adenomas, and on the identification of early carcinoma stages in order to improve the prognosis of patients. After curative resection, an adjuvant therapy is recommended depending on the carcinoma stage that is carried out partly as combination therapy. Patients in stage IV with isolated metastases in liver or lungs can be cured using surgical resection, to some extent after a preceding chemo(immuno)therapy. If there is diffuse metastasis, in the framework of an individualized therapy concept there are different chemotherapeutics and target-oriented substances available, but a cure is unlikely in this case.

Key words

Colorectal carcinoma - hereditary colorectal tumor syndromes - individualized tumor therapy - RAS status

• Literatur

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